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To investigate how combined cystoid spaces and serous retinal detachment affect photoreceptor status and visual acuity at final visit in macular edema associated with branch retinal vein occlusion.Forty-seven consecutive eyes from 47 patients with macular edema associated with branch retinal vein occlusion treated with intravitreal bevacizumab injection were retrospectively reviewed. Foveal pathomorphology on optical coherence tomography images were divided into two groups: those in which combined foveal cystoid spaces and serous retinal detachment were observed at least once (C+S(+)) and those in which they were not observed (C+S(−)). The relationship between foveal pathomorphology and photoreceptor status and logarithm of the minimum angle of resolution at final visit was investigated.Sixteen eyes were categorized as C+S(+), and the final visual acuity of C+S(+) group was significantly worse than that of C+S(−) group compared with no difference at baseline. Intriguingly, combined foveal pathomorphologies during the course were significantly associated with the absence of external limiting membrane and the junction of inner and outer segments at last visit. Using multivariable analysis, final logarithm of the minimum angle of resolution was significantly related to baseline logarithm of the minimum angle of resolution, diabetes, and C+S(+).Combined foveal cystoid spaces and retinal detachment during follow-up predict the disrupted foveal photoreceptors and concomitant poor final visual acuity in branch retinal vein occlusion treated with intravitreal bevacizumab injection.